| NPI | 1760767925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 4733) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9106220) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2020-06-23 |